摘要
目的了解广东地区血流感染(BSI)病原菌的分布及耐药情况,为临床合理用药提供依据。方法收集2013年1月1日至2016年12月31日广州军区广州总医院住院的1 199例疑似BSI老年患者血培养标本,共分离病原菌1 199株,采用全自动细菌鉴定仪对病原菌进行鉴定及药敏试验。结果 1 199株病原菌中革兰阳性菌489株,占40.8%;革兰阴性菌685株,占57.1%;真菌25株,占2.1%。位于检出率前5名的病原菌为凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、金黄色葡萄球菌。病原菌主要分布在重症监护室(ICU)、干部病房和心内科。革兰阳性菌中耐甲氧西林金黄色葡萄球菌的检出率为48.3%,耐甲氧西林凝固酶阴性葡萄球菌的检出率高达88.6%。革兰阴性菌中的大肠埃希菌是BSI最主要的致病菌。2013-2016年,碳青霉烯类药物和替加环素耐药率整体呈直线上升趋势,万古霉素的耐药率逐年上升。结论广东地区老年患者BSI病原菌菌谱分布广泛,常见细菌耐药性仍较严重,临床应根据药敏结果合理选择抗菌药物。
Objective To understand the distribution and drug resistance of pathogenic bacteria of blood stream infection(BSI) in Guangdong,and to provide evidence for rational drug use in clinic. Methods A total of 1 199 strains of pathogenic bacteria were isolated from blood cultures of 1 199 suspected BSI elderly patients hospitalized in Guangzhou General Hospital of Guangzhou Military Region from January 1,2013 to December 31,2016.Pathogenic bacteria was identified and susceptibility test was carried out by automatic bacterial identification instrument. Results Of 1199 strains of pathogenic bacteria,489 strains were gram-positive,accounting for 40.8%,685 strains were gram-negative,accounting for 57.1% and 25 strains were fungi,accounting for 2.1%.The top five detection rates were coagulase negative staphylococcus,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Staphylococcus aureus.The detection rate of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus was 48.3% and 88.6% respectively.Escherichia coli in Gram-negative bacteria was the main pathogen of BSI.From 2013 to 2016,the drug resistance rates of carbapenems and tegacycline increased linearly,and vancomycin resistance rates increased year by year. Conclusion The spectrum of BSI pathogenic bacteria is widely distributed in elderly patients in Guangdong,and the drug resistance of common bacteria is still serious.Antibiotics should be reasonably selected according to the results of drug susceptibility in clinic.
作者
沈燕
曹玲
林田
SHEN Yan;CAO Ling;LIN Tian(School of Nursing,Guangdong Pharmaceutical University,Guangzhou,Guangdong 510310,China;Department of Clinical Laboratory,Guangzhou General Hospital of Guangzhou Military Command,Guangzhou,Guangdong 510310,China)
出处
《现代医药卫生》
2019年第6期816-820,共5页
Journal of Modern Medicine & Health
基金
2015年广东省教育厅研究生教育创新计划项目(2015JGXM-MS37)
关键词
感染/流行病学
血流动力学
细菌
药物耐受性
抗菌药
Infection/epidemiology
Hemodynamics
Bacteria
Drug tolerance
Antibacterial drugs
